1. Today's date (day/month/year):
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2. Name (optional):
       OR      I wish to remain annonymous

3. Date of your initial contact with Graduate Diversity Office (month/year):
JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

4. How did you learn about the Graduate Diversity Office?
program web site
the program director
peers
professors
recruiters
other (please describe below)

5. How did you initially contact the Diversity Office?
email
telephone
visited the office
met the director in person in another setting
other (please describe below)

6. What kinds of services did you receive? (select all that apply)
questions answered via email
detailed telephone conversation
received feedback on application essays
consulted with the director in person
other (please describe below)

7. Using a scale from 1 to 5, with 1 being "not very helpful" and 5 being "extremely helpful," how would you rate your overall experience and the help you received?
1: not very helpful 2: somewhat unhelpful 3: neither helpful or unhelpful 4: somewhat helpful 5: very helpful

8. What aspect of the service rendered could be improved?

9. How important is support for diversity in your choice for graduate school?
not very important        neutral        does not apply         very important

10. How important is this office or service rendered by this office in your decision to stay the course in your graduate program?
not very important        neutral        does not apply         very important